New From NEMSAC: Subcommittee Reports from the November 2024 Meeting

The final National EMS Advisory Council (NEMSAC) meeting of the year took place on November 6-7, 2024. The in-person gathering was held at the Hotel Washington in Washington, DC. The session was also hosted online for remote viewing.

According to EMS.gov, “The NEMSAC consists of 25 members of the EMS community who represent different aspects of the profession. The members are appointed by the Secretary of the Department of Transportation for two-year terms, and each may serve up to two terms.”

Here are the reports from NEMSAC’s six subcommittees, as delivered on November 6. As always, some of the quotations have been edited for clarity and flow. All proposals to advance advisories and letters to their next stages were approved by NEMSAC voting on November 7, 2024.

Money for EMS Remains a Priority

Achieving sustainable funding for EMS remains a hot topic for NEMSAC’s Sustainability & Efficiency Subcommittee. It is taking a two-pronged approach to this problem: “The first advisory—Funding and Reimbursement Strategies for Non-Emergency Out of Hospital Medical Care Provided By Mobile Integrated Health Paramedics and Community Paramedics—we will be discussing tomorrow in our meeting and be looking to move that from draft to interim status,” said Subcommittee Chair Paul Brennan, director of prehospital emergency medical services at Lawrence General Hospital in Lawrence, Massachusetts. “We [also] have a second advisory [on] Establishing Prehospital Physician Practice Reimbursement Models for Improved Patient Care in EMS Physician Oversight that we are proposing to move from draft to interim.”

As well, this subcommittee is working on a Strategies to Address the Crisis of Increased Ambulance Patient Offload Times advisory. “We'll be proposing to move that from research to draft,” Brennan said. “And we have a letter to FICEMS that we will be addressing the EMS wall time crisis in America, which goes hand in hand with the strategies advisory, and we'll be looking to move that to final tomorrow.”

Active Threats, EMS Mental Health, and Peer Review

NEMSAC's Preparedness & Education Subcommittee Chair Lisa Basgall (director of Rice University EMS in Houston) discussed four projects seeking NEMSAC approval. The first is an advisory titled EMS Response to Active Threat Incidents: A Multifaceted Approach To Preparedness And Coordination. It was raised to interim status at the last council meeting.

“We're hoping to bring it to final maturation at this current council meeting tomorrow,” Basgall said. “Additionally, the advisory on Addressing The Mental Health Of EMS Clinicians is in research currently and we're hoping to propose this for draft to the council tomorrow.”

Basgall asked to keep her subcommittee’s advisory on Establishing Protections for EMS Peer Review and Clinical Quality Improvement Activities to Promote Patient Safety and Improved Care in the research phase, “so we have more time to thoughtfully discuss and consider to produce a good advisory,” she said. “And lastly, a letter to FICEMS on the support of the joint position statement on EMS performance measures is currently in interim and we are proposing it for final consideration for the council.”

Work Continues on Equitable Patient Care, Meds and Device Shortages, and Others

NEMSAC’s Equitable Patient Care Subcommittee, chaired by Jason McMullan, associate professor and director of EMS at the University of Cincinnati School Of Medicine, had four advisories to advance at the November 7-8, 2024 meeting. The first advisory, covering Equitable Access to EMS on the Basis of Population Density, had progressed sufficiently to move from draft to interim status. Meanwhile, the subcommittee’s Mitigating Medication Supply and Device Shortages advisory was ready to advance from research to draft status.

Remaining in the research phase is the subcommittee’s Improved and Equal Access to Prehospital Blood Transfusions advisory, which “is certainly the hot topic right now,” said McMullan. “And also still in research is another important topic of development of evidence-based standards for EMS systems’ safe transport of pediatric patients.”

Confronting Violence Against EMS Personnel and Workplace Injuries       

NEMSAC’s Profession Safety Subcommittee is continuing to develop content on quantifying violence against EMS clinicians, and establishing an EMS injury and violence surveillance database. The first “is a follow-up to the letter that we completed or moved to final at our last committee meeting,” said Subcommittee Vice-Chair Kendall McKenzie, who is also chair of the University of Mississippi Medical Center’s (Jackson, MS) Department of Emergency Medicine. Meanwhile, the EMS injury advisory “will remain in research.”

Providing Translation Tools in the Field

Mindful that many languages are spoken in America, the Integration & Technology Subcommittee is working on a document titled Best Practices for Use of Language Translation Tools in The Prehospital Setting, which is currently in draft form. “We're a little bit late in this, but we're hoping in February we can move it to interim. Bidirectional Data Sharing Between EMS and Hospitals is in draft when we're going to ask that we move to interim tomorrow,” said Subcommittee Chair Tom Arkins, a paramedic with Indianapolis EMS.

A second advisory report on Identification and Modification of Biased, Inappropriate, Inflammatory, or Derogatory Language In EMS Documentation to Reduce Biases In Clinical Care is currently in draft, Arkins noted. “We're going to ask to move that to interim tomorrow as well. Universal Identification Bands for Improved Prehospital Patient Tracking and Data: There's really no good information on that, so it's going to stay in the research phase for now. And then we have a letter to FICEMS about the use of artificial intelligence in EMS, and we're hoping to include that in the draft tomorrow.”

Bodycams for EMS

Lastly, NEMSAC Adaptability & Innovation Subcommittee Chair David Fifer (who is also an assistant professor of emergency medical care and director of the paramedic degree program at Eastern Kentucky University) had one update to offer at the November 7 meeting. “We continue to deliberate a letter to FICEMS concerning the use of body-worn cameras in EMS,” Fifer said. “We will be continuing to discuss that again tomorrow during our subcommittee meeting and suggesting that it move forward in the maturation process.”

To learn more about NEMSAC and its activities, go to https://www.ems.gov/resources/national-ems-advisory-council-nemsac/.